MEDICARE: DR. MARIA DE LOURDES MATTEI PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	4642	MA

General Provider Information

NPI Number	:	1083752786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA DE LOURDES MATTEI PH.D.

Provider Business Mailing Address
First Line	:	43 CENTER ST STE 203
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-3062
Country	:	US
Telephone Number	:	413-586-8567
Fax Number	:	413-584-7527

Provider Business Practice Location Address
First Line	:	43 CENTER ST STE 203
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-3062
Country	:	US
Telephone Number	:	413-586-8567
Fax Number	:	413-584-7527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	03/21/2017

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